Provider Demographics
NPI:1821699828
Name:TURNER, TAWAKA JONES
Entity Type:Individual
Prefix:
First Name:TAWAKA
Middle Name:JONES
Last Name:TURNER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8063 GREEN ORCHARD RD APT 23
Mailing Address - Street 2:
Mailing Address - City:GLEN BURNIE
Mailing Address - State:MD
Mailing Address - Zip Code:21061-5121
Mailing Address - Country:US
Mailing Address - Phone:256-933-0206
Mailing Address - Fax:
Practice Address - Street 1:13400 EDGEMEADE RD
Practice Address - Street 2:
Practice Address - City:UPPER MARLBORO
Practice Address - State:MD
Practice Address - Zip Code:20772-8088
Practice Address - Country:US
Practice Address - Phone:240-545-5141
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-05
Last Update Date:2020-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLGP10857101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health